Beinder E, Grancay T, Menéndez T, Singer H, Hofbeck M
Department of Obstetrics and Gynecology, University Hospital of Erlangen/Nuremberg, Germany.
Am J Obstet Gynecol. 2001 Sep;185(3):743-7. doi: 10.1067/mob.2001.117973.
Recent evidence in literature shows that the long QT syndrome accounts for a fraction of the sudden infant death syndrome. Newborn infants with prolongation of the Q-T interval often show sinus bradycardia, which led us to test whether children who were diagnosed with long QT syndrome also show sinus bradycardia in the cardiotocogram before birth.
We identified 18 children who were born from singleton pregnancies at or near term in whom long QT syndrome (corrected QT interval, >0.440 second) was diagnosed after birth or in childhood. Cardiograms during pregnancy and delivery were available from 17 of the 18 children.
The cardiotocogram showed persistent fetal sinus bradycardia (baseline heart rate permanently below 120 beats/min) in 12 of 17 fetuses (71%) with long QT syndrome. Two fetuses had additional intermittent tachyarrhythmias.
Sinus bradycardia in the cardiotocogram during delivery or in pregnancy may indicate long QT syndrome in the fetus. Postnatal electrocardiography should be performed in these children to rule out or confirm a prolongation of the Q-T interval.
文献中的最新证据表明，长QT综合征是婴儿猝死综合征的一部分原因。QT间期延长的新生儿常表现为窦性心动过缓，这促使我们研究产前诊断为长QT综合征的儿童在胎心监护图上是否也表现为窦性心动过缓。
我们确定了18名足月或接近足月单胎妊娠出生的儿童，他们在出生后或儿童期被诊断为长QT综合征（校正QT间期>0.440秒）。18名儿童中有17名可获得孕期和分娩期间的心电图。
17例长QT综合征胎儿中有12例（71%）的胎心监护图显示持续性胎儿窦性心动过缓（基线心率持续低于120次/分钟）。2例胎儿还伴有间歇性快速性心律失常。
分娩期或孕期胎心监护图上的窦性心动过缓可能提示胎儿长QT综合征。这些儿童应在出生后进行心电图检查，以排除或确认QT间期延长。
